• P Tauzin-Fin, M C Krol-Houdek, P Gosse, and P Ballanger.
• Département d'anesthésie-réanimation III, hôpital Pellegrin-Tondu, 5, place Amélie Raba-Léon, 33076 Bordeaux, France. secretariat.ballanger@bu-u-bordeaux2.fr
• Ann Fr Anesth Reanim. 2002 Jun 1; 21 (6): 464-70.

ObjectiveTo investigate the effects of coeliosurgery by catecholamine assays and the use of urapidil in the management of phaeochromocytoma.Study DesignProspective cohort study.PatientsNine consecutive patients from April 1997 to April 2001.MethodsUrapidil (250 mg.j-1) was administered by continuous intravenous infusion three days before surgery and continued throughout anaesthesia. Plasma catecholamine concentrations were measured before surgery, after induction of anaesthesia, during insufflation, after adrenalectomy and in the recovery room. Haemodynamic disorders were treated by nicardipine +/- esmolol bolus doses.ResultsCreation of pneumoperitoneum and adrenal gland manipulations resulted in significant catecholamine releases associated with hypertension in five and eight patients respectively. Preventive urapidil use enabled easy control of blood pressure variations by additive antihypertensive drugs.ConclusionPerioperative alpha 1 blockade by urapidil enables an effective and easy control of acute preoperative haemodynamic changes.

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